No Time to 'Wait and See' on Health Law

Dr. Quentin YoungThe Huffington Post, April 14, 2010

Building the Single-Payer Movement

Having just gone through a grueling, frequently raucous debate on health reform, capped by the narrowest of votes to pass the Obama administration's bill, many activists are now tempted to adopt a "wait and see" attitude on how the new law plays out.

Still others - the hostile, noisy Know-Nothings associated with the Republicans and Tea Party crowd - continue to rail against President Obama's "socialized medicine" plan (a misnomer if there ever was one), and pledge to obstruct or overturn it. Conservatives vow to make political hay out of the law in the run-up to the midterm elections.

Wall Street, on the other hand, is very comfortable with the new legislation. Mutual fund analysts now say it's increasingly clear that the law is beneficial for health industry stocks, particularly for pharmaceutical and medical equipment companies, because there are no "onerous cost controls" in the law. And health insurance company stocks continue to a yearlong trend upward, and the industry's CEO salaries continue to be astronomical.

After all, the health insurers wrote the bill. Sen. Max Baucus was recently caught on tape heaping effusive praise on his aide Elizabeth Fowler for her pivotal role in crafting the legislation. Fowler is a former vice president of WellPoint, the giant health insurer.

Baucus himself, a key actor in this bad movie, was surrounded by health industry lobbyists from the very beginning, and has received over $2.8 million in campaign contributions from these toxic sources over the past few years. That he earned his payoff was demonstrated when Karen Ignagni, the president of America's Health Insurance Plans, congratulated him (during this week's episode of "Frontline") on his handling of the single-payer nonviolent disruption of his Senate Finance Committee hearing after single-payer advocates like Dr. Margaret Flowers were excluded from giving testimony.

Supporters of single-payer national health insurance face several challenges, the chief of which is how to transform the various efforts of single-payer Medicare-for-All activists into a movement for political and legislative success. Among the key tasks are these:

* Educating candidates for political office (and current officeholders) from all political parties about the merits of the single-payer proposal, and offering to advise them on health policy matters.

* Ensuring the reintroduction and largest possible legislative sponsorship for national single-payer bills like Rep. John Conyers' H.R. 676 and Sen. Bernie Sanders' S. 703.

* Supporting efforts (including a change in the new law) to permit states to experiment with their own, independent single-payer models of reform right away.

* Defending Medicare from harmful budget cuts and educating Medicare beneficiaries about their self-interest in improving and expanding the program to cover everyone, i.e. embracing the slogan, "Everybody in, nobody out."

* Continuing our educational work about the merits - nay, the necessity - of adopting a single-payer system. The sooner we initiate a truly universal, egalitarian, humane and efficient system, the sooner the American people will enjoy the high-quality health care our nation and our health professionals are capable of providing.

A major burden the enactment of the new law imposes on single-payer advocates is its timeline. Specifically, major elements in the legislation do not kick in for two, four or even eight years' time.

But "wait and see" is not an option for us. The legislation just passed is completely inadequate to the task at hand.

Under the new law, the suffering and financial hardship imposed on Americans by our private-insurance-based system will largely continue unabated for four more years, and only then be subject to very modest regulation. (Loopholes in the law abound.) Over 50 million people will remain uninsured each year until 2014, which translates into 50,000 preventable deaths annually. A comparable number will remain underinsured, with many vulnerable to medical bankruptcy when serious illness strikes, even after 2014.

Even if the new law works as planned, at least 23 million people will remain uninsured at 2019. So "universal health care" remains a dream deferred.

That spells human misery. This week a new Harvard-based study showed that people with migraine who lack health insurance, or who are on Medicaid, disproportionately suffer from their condition because they can't get access to the standard medications they need to reduce their pain and other symptoms. And that's just one example of the unnecessary suffering that lies in wait.

The unrelenting advocacy of single payer by Physicians for a National Health Program also stems from a careful study of repeatedly unsuccessful experiments with state-based reforms based on private insurance, including the Massachusetts plan (upon which the new law is modeled). The evidence is clear: incremental reforms of this type - based on the private-insurance model - will not work. They invariably succumb to skyrocketing costs.

Single-payer Medicare for All is the reform that's required. Just like almost all other major areas of progress in American life, fundamental health reform requires a movement based on equity, justice, prudence and science that is free of market greed. That movement today is single payer.